[Trauma of the liver and hepatic pedicle]. / Le lesioni multifunzionali del fegato.

Traumatic injuries of the liver and hepatic pedicle secondary to blunt abdominal trauma are unusual and often associated with injuries of other abdominal and/or thoracic organs. These lead the patient to an emergency operation for hemorrhagic shock. The diagnosis of trauma severity and hepatic pedicle involvement is made intraoperatively. Often only one anatomical structure of the hepatic pedicle is involved, whereas involvement of two or all three anatomical structures is rare and associated with a bad prognosis. The management of these injuries still remain one of the most challenging scenario in trauma surgery. The overall experience is not significant. Clear treatment guidelines or management algorithms have not yet been established, in part due to the complexity, severity and variability of these injuries and to the lack of large series with these rare events. Three cases of associated liver and hepatic pedicle injuries treated in our unit are reported.

[The surgery of laparoceles. The postoperative complications]. / Chirurgia dei laparoceli. Complicanze postoperatorie.

The use of prosthetic meshes in incisional hernias repairs is now very attractive, particularly for wide fascial defects; nevertheless the presence of a foreign body and placement technique may be responsible for complications sometimes leading to failure. To evaluate technical problems and complications in incisional hernia surgery the authors reviewed their 5 year experience in 70 patients; 39 mesh repairs and 31 direct sutures of the abdominal wall were performed. Local complications (fistulas, wound hematoma or infections) were more frequent in the former group; PTFE meshes showed a lower resistance to infections, particularly in diabetics, and in three patients partial or total removal was mandatory. Prosthetic meshes showed a marked reduction of recurrences in incisional hernia surgery, but their use leads to more local complications than direct repair; the authors believe that mesh placement must be evaluated for every single patient and not used as a routine procedure.

[Hürthle's tumors of the thyroid: a clinical case and review of the literature]. / Tumori di Hürthle della tiroide: caso clinico e revisione della letteratura.

Hürthle tumors of the thyroid gland are uncommon lesions, histologically related to the well differentiated types of thyroid malignancies. Lesions predominantly composed of Hürthle cells are difficult for pathologists to be diagnosed and, consequently, for surgeons to be properly treated. In this report a case of Hürthle cell carcinoma was firstly treated with hemithyroidectomy plus isthmectomy; once frozen section examination revealed signs of malignancy a total thyroidectomy was performed.

Comparative study with piroxicam and ibuprofen versus placebo in the supportive treatment of minor sports injuries.

Piroxicam (20 mg o.d.), ibuprofen (200 mg t.i.d.) or placebo were added to the conventional treatment in three different groups of professional athletes with soft-tissue injuries. The piroxicam-treated group showed, with a once-a-day only administration, a statistically significant better improvement of various subjective and objective signs of functional damage.